De Cruppe 2005.

Methods	Randomised controlled trial of consultation liaison compared to standard care.
Participants	Consumers (n = 67): consumers referred to a hospital‐based psychosomatic consultation liaison service. Their mean age was 45 years, 42% were male. Somatoform disorders 21, common psychiatric disorders 22, and adjustment disorder or stress reaction 24. Excluded: organic mental disorders; substance‐ and abuse‐related disorders, schizophrenia, schizotypal or delusional disorders, pre‐terminal illness or limited German. Primary care providers (n not reported): general practitioners of a consumer randomised to the intervention group, 62.4% had received certification for psychosomatic primary care. Mental health specialists (n = 5): psychosomatic consultants trained in internal medicine and psychotherapy with one year training. Setting: GP practices in Germany 1998‐9.
Interventions	1. Consultation Liaison (n = 33) Mental health specialist/consumer: initial assessment through hospital psychosomatic consultation liaison service and recommendation for further psychosocial care and therapy. Mental health specialist/primary care provider: one phone‐call (10 min) and one written report. Both incorporated diagnosis, symptom‐related psychosocial findings and therapy recommendations. Primary care provider/consumer: recommendations were made to primary care providers to hold symptom‐based conversations with the client integrating psychosocial aspects every four to six weeks. 2. Standard care (n = 34) Mental health specialist/consumer: initial assessment through hospital psychosomatic consultation liaison service and recommendation for further psychosocial care and therapy (as for consultation liaison).
Outcomes	1. Consumer Symptoms: Beschwerden Liste (general and somatic symptoms, 24 item), Allgemeine Depressionskala (Depressive symptoms, 20 item), State‐Trait Anxiety Inventory (20 item), WHO Global Assessment of Social Functioning (five‐point scale) at 6 and 42 months. Adherence: used recommended psychotherapy treatments at 6 and 42 months. 2. Provider Adherence: followed through with CL recommendations over 6 months.
Notes	As provider sample sizes were not reported, these were assumed to be the same as consumers for provider adherence.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	An independent statistician block randomised consumers by diagnosis.
Allocation concealment (selection bias)	Low risk	See sequence generation.
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Independent statistician was responsible for psychometric tests but responses were self‐reported; however, participants probably did not know whether they were in the active group.
Incomplete outcome data (attrition bias) All outcomes	High risk	Data was reported for those available at follow‐up, loss to follow‐up at 6 months 21%, 42 months 28%.
Selective reporting (reporting bias)	High risk	The only consumer outcome reported was use of psychotherapies. Primary care provider adherence was reported but sample sizes were not reported.
Other bias	Unclear risk	No other bias identified.